放疗剂量与鼻咽癌患者胸锁乳突肌体积变化及晚反应关系

doi:10.3760/cma.j.issn.1004-4221.2017.01.001

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Abstract

Objective To investigate the relationship of radiation dose with the volume and late toxicity of the sternocleidomastoid muscle (SM) in patients with nasopharyngeal carcinoma. Methods SM was divided into upper part and lower part based on the lower edge of cricoid cartilage. Patients were divided into three groups according to the prescribed dose for clinical target volume at the lower neck (CTV₂)(0,54,60 Gy). The dosimetric parameters included D_mean, V₆₆, and V₆₀ for the upper, lower, and whole SM. SM was delineated and the volume was calculated on computed tomography images in the treatment planning system before and at 6, 12, and 18 months after treatment. The anteroposterior and transversal diameters of SM at C₃-C₄, C₄-C₅, C₅-C₆, and C₆-C₇ levels were measured and recorded. Late toxicity of neck skin and SM was evaluated according to the Common Terminology Criteria for Adverse Events V₄.0 criteria. Between-group comparison was made by t-test or Kruskal-Wallis non-parametric test. Between-group comparison of the sample rate was made by one-way analysis of variance. The correlation analysis was made by Spearman correlation. Results There were significant difference in SM volume between the three time points after treatment (P=0.000). At 12 or 18 months after treatment, the volume of SM wasignificantly reduced (P=0.000,0.000);the reduction in SM volume was significantly correlated with V₆₆ of the SM and the upper SM (P=0.015,0.020). At 18 months after treatment, SM fibrosis was significantly correlated with V₆₀ of the upper SM (P=0.030);the fibrosis of neck skin was significantly correlated with the D_mean and V₆₀ of the upper SM (P=0.029,0.005). Conclusions In order to prevent the incidence of the fibrosis of neck skin and SM, the dose homogeneity should be as high as possible, while the number of hot spots should be as small as possible.

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	Sang Xuejin
	Wang Xiaoyan
	Yang Zhining
	Huang Baotian
	Lin Zhixiong

Key words： Nasopharyngeal neoplasms/radiotherapy Radiation dose Sternocleidomastoid muscle Late toxicity

Received: 20 April 2016

Corresponding Authors: Lin Zhixiong,Email:120110765@qq.com

Cite this article:

Sang Xuejin,Wang Xiaoyan,Yang Zhining et al. Relation of radiotherapy dose and sternocleidomastoid muscle (SM) mass or late response in patients with nasopharyngeal carcinoma[J]. Chinese Journal of Radiation Oncology, 2017, 26(1): 1-5.

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http://journal12.magtechjournal.com/Jweb_fszlx/EN/10.3760/cma.j.issn.1004-4221.2017.01.001 OR http://journal12.magtechjournal.com/Jweb_fszlx/EN/Y2017/V26/I1/1

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